The Psilocybin Pain Study is a Phase 2 open label, single center, concurrent mixed-methods trial that aims to assess the feasibility of psilocybin-assisted psychotherapy to alleviate opioid-refractory pain in patients with advanced cancer. Participants will receive 25 mg of psilocybin and undergo psychotherapy sessions in the weeks before and after their dosing day. Study participation will span approximately 20 weeks, including a 2-6 week screening period. It will consist of three pre-dosing preparatory sessions (1.5 hours each), an experimental session/dosing day (6-8 hours), two post-dosing integrative sessions (1.5 hours each), and five follow-up visits (1 hour each). Participants will complete a post-dosing interview, along with two optional pre-dosing and follow-up interviews.

• Symptoms/Population: Adult patients with advanced cancer experiencing opioid refractory pain (BPI ≥ 4/10) at DFCI, MGH, or associated satellites.
• Eligibility requirements:
  • Inclusion criteria: 18+ years old; advanced cancer diagnosis; pain ≥ 4/10 on BPI; taking opioids for pain with OME ≥ 120mg/day or unable to tolerate systemic opioid side effects; seeing palliative care at DFCI, MGH, or associated satellites; ECOG performance status ≤ 2.
  • Exclusion criteria: significant suicide risk; psychiatric diagnoses with psychotic features; family history of schizophrenia or bipolar disorder; concomitant medications; brain tumors/metastases; certain liver conditions; heart conditions/history of heart problems.